Lessons From A Day In The ER

I spent an entire day in a hospital emergency room for something that turned out to be a very minor medical matter.

But it was an education about our health insurance system.

I have coverage through my wife’s employer and her contributions to the plan. Medicare as a backup.

A thin-curtain-partition away from me was a 47-year-old local man with high blood pressure, and head and groin pains so severe that he could not stand up. He had no health insurance.

He’s a “cash basis” worker for his brother, has no property or investments. He fell through the crack on QUEST for reasons seemingly traced to his inability to navigate the paperwork of the state’s low-income health-care safety net.

A nurse asked if he was taking medicine for his high blood pressure. “Sometimes, when I can afford it,” he said.

He was being admitted for longer-term observation and it appeared from what I heard (you can hear everything in a madhouse ER) that the hospital would be eating the costs.

Why do we keep slapping the cost of the uninsured on even the not-for-profit hospitals?

I’m not sure I can fully support making health insurance a cost for employers. They cannot control the health habits of their workers but they pay for health abuse in the workforce.

I’m a universal health care fan, preferably with the U.S. government as the single payer.

I’m no socialist. I think capitalism is a good thing. It built our railroads, our military prowess and - in the case of industrialist Henry J. Kaiser - our Kaiser Permanente hospital system.

But sometimes government has to be an arbiter between unbridled capitalism and the public need for health care, safety and the general welfare. Letting health care and medicine sales stay in the hands of those who say “pay me my price or do without” is not good governance.

I know there are people who will game a universal health insurance plan. Writers often say that most people don’t want to be on welfare; it’s shaming. Truth is that there are some people who’d just as soon go through life on somebody else’s dime.

So yes, we the universal insurance payers through our taxes will be scammed by some who could pay but manage not to.

I guess that’s a price you pay in a society that decides not to let any of its members fall through the cracks.

So rather than any national plan that includes some of us buying private health insurance, some of us getting it through our employers and some of us falling back on the dole, I vote for one national insurance plan, with all doctor, hospital and drug fees negotiated by the government administrator, and everyone required to pay in.

But I know many of you want to do it yourself through some non-government provider. That’s going to be a stickler.

It’s doable but probably will be lobbied to death by private insurers, private hospitals, drug companies and many doctors. And plenty of you ordinary users who insist on doing it your own way.

If the court master studying commercial use of Kapiolani Park needs more evidence, he can look at this month’s Pro Bowl In The Park event.

Most of the park space was utilized to sell geegaws, food and NFL merchandise. Some recreation but mostly commerce booths. On the beach side of the park, the city authorized tents selling jewelry and assorted trinkets.

Clear violations of the park trust which prohibits commercial use.

We did ourselves a disservice in strictly applying the Sunshine Law to those transit experts who picked the fixed-guideway transit technology for Honolulu.

The five panelists were prohibited from meeting in other than open sessions.

That’s no way to come to a technical, non-political decision. They needed to challenge each other, no holds barred, and no in-public politeness required. There was a lot of private, proprietary information among the 10 companies that competed for the contract.

So we got five experts with five pieces of the transit puzzle and they could not talk among themselves on how to put them all together.

We’ll never know if we got the best or just a quickie, one-week, majority rules decision.

Nobody can under-estimate the powerful military message transmitted by the USS Lake Erie’s shoot-down off Kauai of an errant American spy satellite last week.

It puts us years ahead of Russia and China and says we can probably knock down enemy missiles and eyes-in-the-sky at will.

It’s an enormous leap of technology and gives the U.S. a huge stick to use in weapons negotiations.